Well-known antibiotic amoxycillin found to be ineffective cough treatment

A antibiotic commonly prescribed for infections including coughs and bronchitis is ineffective at relieving symptoms, and may actually be harmful if overused, according to a new European study.

The study of 2,061 adults, published in The Lancet Infectious Diseases, found patients prescribed amoxycillin did not recover more quickly or have significantly fewer symptoms than those who received no medication.

“Using amoxycillin to treat respiratory infections in patients not suspected of having pneumonia is not likely to help and could be harmful,” said Professor Paul Little from the University of Southampton in the UK who led the research.

He added that overuse of antibiotics could also lead to side effects such diarrhoea, rash, and vomiting, in addition to the development of resistance.

The study shows that unless a patient has pneumonia, the risk of side-effects outweighs the small benefit of treatment with the antibiotic, said Dr. Trent Yarwood, infectious diseases physician at Queensland Health.

“Thirty patients would need to be treated to prevent one having a worsening of their symptoms, but only 21 would need to be treated to result in an antibiotic-related side-effect (rash, nausea or diarrhoea),” Dr. Yarwood said.

However Dr. Michael Tam, GP and lecturer in primary care at the University of New South Wales, said the study doesn’t mean that antibiotics should never be used.

“For the most part, these findings confirm what we think to be best practice for lower respiratory tract infections that are not suspected to be pneumonia,” Dr. Tam said.

“For instance, the Australia based “eTG Complete” guidelines already recommend against the use of antibiotics for acute bronchitis.”

Dr. Tam said, as always, an individual seeking care should have a discussion with their GP on what would be the most appropriate treatment for them, at the time, in their specific situation.

“Our results show that most people get better on their own. But, given that a small number of patients will benefit from antibiotics the challenge remains to identify these individuals,” Professor Little said.

“Little and colleagues have generated convincing data that should encourage physicians in primary care to refrain from antibiotic treatment in low-risk patients in whom pneumonia is not suspected,” said Dr. Philipp Schuetz from the Kantonsspital Aarau in Switzerland.

“Whether this one size- fits-all approach can be further improved remains to be seen. Guidance from measurements of specific blood biomarkers of bacterial infection might help to identify the few individuals who will benefit from antibiotics despite the apparent absence of pneumonia and avoid the toxic effects and costs of those drugs and the development of resistance in other patients,” Dr. Schuetz said.